Dr Gabrielle Silver
CEO CHS Healthcare
Recent data has shown a reducing pressure from Covid-19 on hospitals, with the total number of people in hospital with Covid-19 decreasing each day. As of 14 April, there were 1,972 people in hospitals across England with Covid-19, which is 94% fewer people than at the peak of 34,000 in January. Furthermore, deaths from Covid-19 have also fallen, with the daily average over the past week equalling 28 deaths per day.
But while this data can be seen as relatively good news and with the vaccine rollout currently being deemed a success and major contributor to the reduction in community transmission, recent data from NHS England has raised alarm with the rise in backlog of patients awaiting elective care at unprecedented levels.
Figures from NHS England have confirmed that approximately 4.7 million people were waiting for routine operations and procedures in England in February – the most since 2007. The number of people having to wait more than 52 weeks to start hospital treatment also stood at 387,885 in February – the highest number for any calendar month since December 2007. One year earlier, in February 2020, the number stood at just 1,613.
Additionally, as of 4 April, there are over 10,000 beds in England being occupied by super stranded patients (patients who have been in hospital for over 21 days).
Patient flow lies at the heart of reducing waiting lists, and the government has committed £594m from April to September 2021 to support this. Prime Minister Boris Johnson has said the government would “make sure that we give the NHS all the funding that it needs…to beat the backlog”.
Funding helps but patient flow is complicated – if it were easy we wouldn’t be discussing it with such regularity. We need to learn lessons from winters past. To make the difference required, funding will need to be put to work in the most impactful way. Being clear about what structures deliver results and not shoring up those which don’t, aiming to achieve better than minimums defined in guidance and investing in relationships with providers and partners will help ensure the fly-wheel of patient flow can be kick started and maintained.
The NHS has had a dreadful time and getting patient-flow right so that elective surgery can be delivered at pace won’t be easy. Staff are exhausted and patients will become increasing high acuity as they wait. All of this against the backdrop of a third wave and unknown variants is a worrying thought.
The NHS is held in high regard by the public – never more so than now. Public opinion will carry a long way but these waiting lists are not comparable to anything we have seen before. What we must avoid is a situation where this problem becomes the NHS’ alone or a problem which has to be solved by the centre. Recent news about dodgy procurement may hit headlines but in reality procurement in the NHS is highly structured and extremely well managed. Constraining trusts and CCGs from making decisions about how they utilise funding would be corrosive for the NHS itself. An aging population and the elective backlog will continue to demand more from the NHS – it needs to be supported with appropriate funding and the support of partners.
One of the benefits of the NHS is that surrounding it there is a health sector made up of organisations of all shapes and sizes willing to support this next national challenge. We know what’s coming and therefore we can act with foresight and thoughtfulness about what is really going to make a difference and what we know can make a difference. What we can’t let happen is for the NHS to be left to manage this all on its own out of a misguided belief that others are seeking to take advantage. It couldn’t be further from the truth.